The story of how the pandemic hit the United States has changed tremendously over time. The first wave hit exactly where it would have been expected, in the largest cities with dense populations and high international travel. While this first phase of the disease was devastating in March and April, the number of new cases reported during this period peaked at under 37,000 cases per day. When more tests went online, those numbers actually declined to May and June as state-level social distancing rules put a brake on outbreaks in the northeast.
The total number of deaths in the United States by the end of May was devastating … but what has happened since then is worse in every way. That number has more than doubled. And there are all signs that it could double again.
Over time, the list of states with most cases resembles the list of states by population. There are some very notable differences, however.
Population ranking / COVID-19 ranking
Rank by population
Rank according to COVID-19 cases
The top of the chart, which in turn reflects these large population centers, might fit closely together, but things fall apart on the list. States like Arizona, which is number 14 by population, are number 8 in COVID-19 cases. Georgia and North Carolina are also high on the list for COVID-19 than when looking at population. Meanwhile, states like Pennsylvania and Michigan actually have far fewer numbers of COVID-19 cases than their populations could predict.
This is because, even nine months after the US outbreak, and despite the lack of travel restrictions, cases of the disease are not evenly distributed across the country. Decisions made at the state and local levels have a huge impact on state and regional outcomes.
As summer came, pressure from Trump to reopen states – and Republican governors eager to obey – created a new, even bigger surge in the south. Florida and Texas, which until then had suffered relatively easily from the coronavirus, shot into the charts. While most states had instituted some form of home order or social distancing in April, states like Florida and Missouri were quick to drop any pretexts to impose restrictions on businesses. This willingness to follow Trump's instructions appeared in the health statistics within a few weeks. In terms of cases per population, New York moved from the top position to 18th. Of the top 10 states in terms of cases per population, only one state – Louisiana – has a Democratic governor.
By the end of summer, Trump insisted on reopening schools. Again, Republican governors and local politicians dutifully agreed, although every study found that children transmit COVID-19 at least as well as adults. Predictable results are achieved at the beginning of autumn.
Active cases of COVID-19 hit a new high on Monday in North Dakota for a fifth straight day, while coronavirus-related hospitalizations rose steadily. https://t.co/ulXPhhvkEY
– The Bismarck Tribune (@bistrib) October 12, 2020
North Dakota wasn't alone. On Monday came South Dakota, Idaho, New Mexico, Oklahoma, Colorado, Kansas, Wisconsin, Nebraska, West Virginia, Indiana, Ohio, Illinois, Wyoming, Montana and Kentucky. Some of these states, like Kentucky and New Mexico, have Democratic governors who have done a good job protecting citizens up to this point. Kentucky ranks 35th when it comes to cases per population. New Mexico is number 38.
The fact that these states have record weeks is certainly worrying, but it is much less worrying than a record week in South Dakota when Trump held his mask-free spread event at Mt. Rushmore on July 4th. That state is number 6 in terms of population. North Dakota is number 2. It is slated to be number 1 – which is sure to be a proud achievement for Republican Governor Doug Burgum. There are 12 states where the number of people who tested positive exceeded 3% of the total population. Eleven of these states have Republican leadership.
As the numbers rise, a new report in the Journal of the American Medical Association conducts the same analysis carried out at Daily Kos in September, comparing Trump's effectiveness with that of executives in other countries. And it comes to the same conclusions.
If US death rates were comparable to Australia, the US would have 187,661 fewer COVID-19 deaths (94% of reported deaths) and, if comparable to Canada, 117 622 fewer deaths (59%).
Had Donald Trump actually put in place national social distancing restrictions, a federal testing and contact tracing system, and a national mask mandate, the number of American deaths would be a fraction of what Americans actually saw. The loss of life, the destruction of the economy, the damage to the nation's reputation, the demolition of institutions and the loss of trust … all of these were totally avoidable and absolutely unforgivable.